Abstract
Purpose: :
Initially transconjunctival sutureless vitrectomy (TSV) was only indicated for simple vitreoretinal surgery. Combined with constellation system, the 25G+-TSV improve drawbacks. The Topcon OMS-800 OFFISS lens system (OFFISS system) is a non-contact wild field lens system which makes surgeon more conveniently and completely to perform vitrectomy without scleral indentation. The purpose of the study is to compare the visual improvement, surgical time, complications, and patients’ discomfort between the combination of these two newly developed instruments and traditional 20G vitrectomy (20G-PPV) in management of simple and complicated vitreoretinal disease
Methods: :
Retrospective analyses of the medical records. 131 eyes in 126 patients received 20G-PPV from Dec. 2009 to Dec. 2010. 4 eyes in 4 patients received 23G-TSV, and 29 eyes in 27 patients received 25G+-TSV from Jun. 2011 to Aug. 2011. The diagnoses include rhegmatogenous /giant tear/tractional RD, macular hole, lens dislocation , macular epiretinal membrane, vitreous hemorrhage, removal of silocone oil, and IOFB. All 20G-PPV surgeries were performed with ACCURUS System plus traditional surgical contact lens. All 23G-TSV and 25G+-TSV surgeries were performed with constellation plus OFFISS system. Lenses that were significantly cataractous were extracted before the vitrectomy. Patients received 25G+-TSV or 23G-TSV were enrolled in the same group for anaylasis
Results: :
All patients had a complete examination at 1 months after surgery. There was no significant difference in postoperative BCVA between the 2 group, but postoperative BCVA improved significantly in each group (decrease>0.2 logMAR units). No significant difference in surgical time, even in subgroup analysis for similar procedure. Subgroups anaylasis for the same diagnoses revealed no significant difference in BCVA improvement and surgical time between two groups. There was no significant difference in hypotony, IOP elevation, chroidal detechment, and hyphema between two groups. A trend of more postoperative vitreous hemorrhage noted in sutureless group (p=0.0532). Retinal break within arcade occurred significantly more and subjective discomfort after surgery were significantly lower in sutureless group,respectively
Conclusions: :
Our findings indicate that 25G+-TSV/23G-TSV with constellation plus OFFISS Lens System is a feasible and effective treatment for complicated vitreoretinal disease and leads to comparable visual outcomes and complications with traditional 20G PPV
Keywords: vitreoretinal surgery • clinical (human) or epidemiologic studies: systems/equipment/techniques • clinical (human) or epidemiologic studies: outcomes/complications